饮水氟含量与儿童肾损害的暴露-效应关系

The dose-effect relationship of water fluoride levels and renal damage in children

目的 阐明饮水氟含量与儿童肾损害的剂量-效应关系,并观察饮水氟含量相同的地区氟斑牙患者与高氟负荷人群之间肾功能有无差异。方法 根据饮水氟含量和是否患氟斑牙将2 10名儿童分为七组,测定各组人群尿和血清氟含量及尿液N 乙酰氨基葡萄糖苷酶(NAG)和γ谷氨酰转移酶(γ-GT)活性。结果 氟中毒病区人群尿和血清氟含量均高于对照组,并随饮水氟含量增加而升高;饮水氟含量为2 .15～2 . 96mg /L的地区氟斑牙患者及饮水氟含量>3 0mg/ L的地区高氟负荷人群和氟斑牙患者尿NAG和γ- GT活性均显著高于对照组,并均存在显著的剂量-效应关系;饮水氟含量相同的地区氟斑牙患者和高氟负荷人群尿NAG和γ- GT活性无显著性差异。结论 饮用氟含量>2. 0mg /L的水可导致儿童肾损害,且损害程度随饮水氟含量增加而增强;肾功能损害程度与是否患氟斑牙无直接关系,主要取决于饮水中的氟含量。

Objective To explore the dose-effect relationship of water fluoride levels and renal damage in children and observe the difference of renal function between high-loaded fluoride people and dental fluorosis people in the same water fluoride level region. Methods 210 children were divided into seven groups in term of drinking water fluoride levels and whether they suffered from dental fluorosis. Fluoride concentrations in urine and serum and activities of urine NAG and γ-GT were determined. Results The urine and serum fluoride of high-loaded fluoride people and dental fluorosis people increased compared with control, moreover fluoride contents in urine and serum increased gradually with the increase of fluoride level in drinking water. Urine NAG and γ-GT activities significantly increased in dental fluorosis people from area of 2.58 mg/L fluoride in drinking water and in those two groups from area of 4.51 mg/L fluoride in drinking water. Moreover, there existed an obvious dose-effect relationship between the drinking water fluoride concentration and NAG andγ-GT activity. Conclusion Over 2.0 mg/L fluoride in drinking water can cause renal damage in children, and the damage degree increases with the dinking water fluoride content. Renal damage degree is not related to whether the children suffered from dental fluorosis and mainly due to water fluoride concentration.